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Keto
The Keto FAQ: https://www.reddit.com/r/keto/wiki/faq New Keto Calculator: https://www.reddit.com/r/keto/comments/6nmxn3/new_keto_calculator_big_update/ Keto Food List (net carbs): https://docs.google.com/spreadsheets/d/1GYelPA7X5svfkWaKXB4zKd3NmpEfX6W24mS8lA3Qx-o/edit#gid=0 Keto and sweetener: https://www.reddit.com/r/keto/comments/5lrp3l/sweeteners_and_keto_with_all_the_new_people_for/ Intro video on Ketosis: https://www.youtube.com/watch?v=Dan8qtgQRi8 Keto Nutrient Requirements: http://i.imgur.com/optmFTF.png The science of Keto: What is Keto? It’s a diet with a little sugar…. lots of fat… and a moderate amount of protein. * You restrict your carbohydrate intake to lower your blood sugar. * You eat fat for energy… and to feel full. * You eat protein (but not too much) for muscle health. At its simplest keto is a low carb diet. How to follow the diet isn’t that interesting. There are dos & don’ts and tricks & tips and pitfalls to watch for. If you want to know what those are seek out /r/keto for more information. What is interesting is the nutrition science that underpins the diet. It is commonly misunderstood. That misunderstanding prompts the concern trolls, the know-it-alls, and the falsely-qualified to hate on keto and those who follow it. To avoid being an ignorant hater, here is what you need to know… Energy, Energy All The Time Humans eat inconsistently and are just fine. Unlike cattle, who need to graze continually, we can eat episodically through the day. If the composition of our diet changes from meal-to-meal or day-to-day that’s ok too. Our ability to store energy gives us the power to eat what we want, when we want. This magic happens because we have two primary reservoirs — or storage areas — for energy. * For short term use, we store energy in our guts. * For medium to long term use, we store it as body fat. (There is also glycogen in the liver and the muscles) Hormones and enzymes regulate which reserve locations are filled up, by how much, how often. The hormones testosterone, estrogen, adrenaline, cortisol (the stress hormone), and insulin are known to regulate energy storage. (Weight gain resulting from the hormone changes during puberty, menopause/andropause, and pregnancy point to this being true.) When you get fat (and stay fat) it is because you have a disorder with one of these hormones. How We Get Fat On a typical day, a typical person is able to move around using the energy in their circulatory system. The person eats. The gut transforms the food into energy and off it whooshes via the circulatory system to nourish the body. If there are excess nutrients after the meal, the body shuttles those nutrients into the fat cells. This is temporary. As the nutrients in the circulatory system exhaust themselves, they are replenished by the reserves in the fat cells. (This is why you can sleep through the night without wanting a sandwich.) Eventually these reserves too are expended. Then our body signals that it is hungry. We have another meal and the cycle repeats itself. But another meal isn’t always a guarantee… so the body is smart enough to lock away some energy for longterm use… just in case. An enzyme called lipoprotein lipase (LPL) locks energy in the fat cells for this purpose. Another enzyme — hormone-sensitive lipase (HSL) — lets it out again. These enzymes are regulated by hormones. Of all the hormones, insulin is the biggest promotor of LPL. Insulin is also the biggest inhibitor of HSL. The equation is pretty simple: lots of insulin means lots of LPL… that leads to obesity. Suppressing insulin means more HSL… and that leads to weight loss. Insulin The digestive tract processes food according to how easy it can be converted to energy. The easier the access, the sooner the food is digested. Foods with lots of sugar get digested quickly. The more refined the sugar, the easier it is. To avoid an overflow of plentiful, easy-to-produce energy your body enlists insulin to monitor the blood sugar. The more sugar in your diet, the more insulin is required to manage your blood. As mentioned, insulin encourages fat storage. But there is also another nasty side-effect of lots of insulin. When insulin levels are high, your body assumes that energy is abundant so it shuts down the pathways to the liver and the muscles. You deplete your energy reserves quicker, so you get hungry again sooner. In reality, your body is fine; you have lots of energy in reserve, just your body doesn’t know it. In practice, premature hunger leads to continual over-eating…. making things worse. Ketosis The keto diet short-circuits the blood-sugar/insulin/gluttony loop by restricting your carb intake. When you slash sugar our of your diet, your body continues as before… sourcing energy… first from your gut… then from the temporary reserves… and then — before you are prompted to eat again — from your liver. In the short term the liver raids its glycogen stores. In the long term, once your body has adapted, the liver forgoes the glycogen. It harvests fatty acids to make ketone bodies. Ketone bodies, in turn, are converted into energy by individual cells and by the brain. The production and assimilation of the ketone bodies is called ketosis. People on the keto diet aim to perpetuate the state of ketosis. This allows them to maintain their normal energy requirements. Their insulin production is suppressed. This promotes the creation of HSL. HSL ‘unlocks’ fat in longterm storage. That fat is released into the blood stream and can be consumed by the liver to create more ketones. The cycle perpetuates itself. “But that can’t be good for you?” Ketosis is a natural process. There is nothing weird or unsafe about it. Arguably it was everyone’s natural state before the human race summitted sugar mountain at the end of the 19th century. Mental clarity can be maintained or improved. Energy levels are the same or better. There are lots of other benefits to losing weight as well. Health concerns are better framed — not in terms of ketosis — but in terms of sugar: in what scenarios is it good for you? It will likely be 40 years before there is actual consensus about that. “No seriously I am afraid you are going to kill yourself.” Those undeterred by restricting sugar are sometimes concerned instead with consuming a high amount of fat. This reaction can be amplified in a number of different ways. If the person is a vegetarian, or against cruelty towards animals, the amount of fat in this diet may seem problematic for logistical or moral grounds. It needn’t be. Vegetarians can maintain ketosis without too much extra trouble. Seek out /r/vegetarianketo to see how. If the person came of age before the diabetes epidemic swept the United States they may be enamored with the idea — unfounded — that eating fat makes you fat. There is no evidence this is true. Eating fat doesn’t give you heart disease either. These were common misconceptions in America from the Eisenhower era through Jane Fonda’s Jazzercise. They have been debunked. “But what about calories and exercise?” It is helpful to understand you needn’t starve or be a super-athlete to be slim. Yes anorexia is a thing.You will waste away if you starve yourself. That’s not controversial. And yes fitness and fatloss are related. Everyone knows that…but the relationship between exercise and body fat is complicated. For instance… you can easily gain a few pounds a year… even if you run every day. Especially if you are older. How can that be? Remember that obesity is a hormone disorder… if insulin is promoting LPL while inhibiting HSL production, it doesn’t really matter what your caloric intake or energy expenditure is. You are going to get fat regardless. “But counting calories still works.” Sure, but it’s not required for Keto. A caloric deficit means that your energy reserves are depleted faster. Assuming insulin levels are low and HSL levels high, the fat in longterm storage may be drawn on sooner. But that is not a certainty. A lower caloric intake will eventually lower your metabolic rate. In that scenario, you are no better off. The bottom line is it’s the quality of your diet that matters, not the quantity. “But what about cardio?” Again you don’t need to be fit to be slim. Exercise is not required to lose weight on Keto. Does it hurt? Not really — but exercise will increase your metabolic rate and prompt you to eat more. Unless you are willing to sustain your new appetite with a consistent amount of exercise, then don’t worry about it. “Keto sounds like Atkins and Atkins will give you a heart attack.” There are a number of low carb diets out there. The Atkins diet is the most famous. Keto differs from Atkins in so far as ‘healthy carbs’ are not allowed for Keto. There is no balancing or fine-tuning sugar intake as your goal weight approaches… as there is on Atkins. Atkins was demonized in the 80’s and 90’s for it’s high fat content. This was baseless. Worries about fat were also bundled with a hysteria about cholesterol. “Yeah what about cholesterol?” Generally Keto improves levels of HDL (the good cholesterol). It does not typically raise levels of LDL (the bad cholesterol) either. There is a phenomena that is prompted by keto, called ‘transient hypercholesterolemia’, that can boost ones cholesterol temporarily. Cholesterol can be stored in adipose tissue and be 'mobilized' during weight loss. It spikes then subsidizes. This apparently only affects some people. “But all the red meat? Oy vey!” Eating red meat is not required to succeed on keto. Red meat doesn’t give you heart trouble, make you fat, or raise your cholesterol…. like some people believe. Red meat can be problematic if it has nitrates in it…. buy meat that doesn’t. And red meat may be a concern due to the diet and hormones and things given to the livestock. These things might lead to cancer. No one is really sure. If you are worried, buy grass-fed. “No fruit. That’s insane. What about an apple a day?” Fructose doesn’t initiate an insulin response. That’s true. The sugar in fruit is (partially) fructose. That is also true. Eating fruit should be OK for keto then? Kind of. The research into high-fructose corn syrup has revealed that a fructose/glucose combination can be really bad for you. The research into whether a fructose/glucose combination sourced directly from whole fruit is kind of hand wavy. Some assume that it’s bad… it follows from the corn-syrup research that it would be… but the research is pretty thin. For simplicity’s sake Ketoers typically avoid fruit… but that may prove to be the mere orthodox position over the long run. “But what about thermodynamics bro?” Remember that everybody poops. Some claim the laws of thermodynamics prevent HSL from releasing fat from longterm storage without a corresponding energy deficit in the body (energy in must equal the energy out). This is misguided on two counts: * 1) HSL production is regulated by insulin. Insulin levels are governed by the sugar consumed — not the total energy amount consumed in the diet or the total energy stored by the body. A deficit isn’t required to make HSL… low insulin is. * 2) The law of conservation of mass assumes a closed system. The human body is not a closed system. You poop, breath, move and heat-up. If the fatty acids that are released by the HSL aren’t needed by the body, they are simply expelled. No balancing is required. “But… but… what about Weight Watchers, and SuperSize Me, and Jenny Craig, and Dean Ornish, and the Biggest Loser, and the food pyramid, and that dietician I sat next to on a plane once?” I know. All wrong… on the portion control issue at least. “Huh?” The short version: Nutrition scientists in the USA are just now warming to the idea that some calories are better for you than other calories. The long version is complicated, involving a line of study (with a 200 year pedigree) that terminated and was forgotten in Germany between the wars. Because: Nazis, ego, and American industry. We won’t get into that. Just know for now… the root of the obesity crisis in the US is not — as most people believe — too much food, too little exercise, and people with too little self-control. And keto is safe. Got it? KCKO #1 previously this post claimed protein was stored in the muscles. This has been corrected. Energy is stored as glycogen in the muscles. I regret the error. #2 previously this post mis-characterized how the adipose cholesterol stores are effected by weight loss. Transient hypercholesterolemia causes LDL to spike. How and why this happens can be researched on its own.